BACK PAIN: CHIROPRACTORS FIND NEW AWARENESS OF THEIR HANDS-ON TECHNIQUE THANKS TO RESEARCH

Chiropractors, long maligned in the medical community and dismissed as "quacks," are enjoying a new acceptance of their profession.

Several recent scientific studies reveal that chiropractic manipulation has merit.

"Chiropractic is one of the best kept secrets," said Cape Girardeau chiropractor Roy Meyer. "Chiropractic patients have always known the value of treatment, now the medical field knows also. The information is out. It's not a secret anymore."

Meyer is president of the Missouri State Board of Chiropractic Examiners, the state's equivalent to the medical profession's Board of Healing Arts.

The six-member chiropractic board reviews all applications for licenses and serves as a review body responding to complaints about chiropractors.

Chiropractors and their loyal patients have long believed that manipulation works. But the profession lacked substantive, scientific research to uphold their claims.

Gradually though, that's changed. Recently released research into spinal manipulation and chiropractic shows that it's an effective treatment for low back pain.

The British Medical Journal in June 1990 reported findings of a scientific study that compared chiropractic and hospital outpatient treatment for low back pain of mechanical origin.

"The results leave little doubt that chiropractic is more effective than conventional hospital outpatient treatment," the report states.

After two years, the condition of patients treated by chiropractic had improved 7 percent more than those treated in hospital. Of those with jobs, 21 percent of patients given chiropractic missed work because of back pain, compared with 35 percent of hospital patients.

The British research suggests chiropractic treatment could reduce employee "sick days" in that country by 290,000 over two years.

The report states: "Whatever the explanation for the difference between the two approaches, this pragmatic comparison of two types of treatment used in day-to-day practice shows that patients treated by chiropractors were not only no worse off than those treated in hospital, but almost certainly fared considerably better and that they maintained their improvement for at least two years."

In the United States, the Rand Corporation also studied the appropriateness of spinal manipulation for low back pain. Results were published in June 1991. The study was conducted by a panel of medical experts including three chiropractors, one osteopath and five medical doctors.

The expert panel agreed that spinal manipulation was appropriate for the most common forms of low back pain.

The Rand panel also found some gray areas. They were unable to agree if manipulation was appropriate for some types of patients, and found that manipulation could be fruitless or harmful for some patients.

But overall, the research was a boost for chiropractors. Similar results now appear regularly in professional journals.

Local chiropractor Stephen L. Gibson said new studies on the effects of chiropractic treatment cross his desk nearly every week. "Many of these studies are being done by MDs," he said. "And we're pleased with the results.

"All the new studies show benefits of chiropractic and manipulation," Gibson said. "The treatment is quicker and cheaper to get well, and patients are off work about half the time."

Even though positive research continues to emerge, Meyer said it will take some time before old beliefs are dispelled.

Years ago, a split occurred between chiropractors and the medical profession concerning the chiropractors' basic beliefs.

Chiropractors believe that back pain and a number of other maladies can be treated by manipulation, the physical movement of joints past their normal range of motion. In their view, manipulation relieves aching backs because it restores normal mobility to vertebral joints that are abnormally stiff, altering the function of adjacent muscles and nerves.

Meyer said, "The split away from the medical practice meant that chiropractic did not get funding for research or for colleges."

Also, it was against the medical code of ethics for a medical doctor to associate with a chiropractor. Chiropractors were labeled "quacks," Meyer said.

The division continued until the mid-1980s when an anti-trust case found that the American Medical Association was working against the chiropractic profession.

"After that decision things really started opening up," Meyer said. "There was more cooperation between chiropractors and medicine. We now have access to labs, CT-MRIs, bone scans."

At the same time, chiropractors began to open themselves to independent and scientific study.

Meyer said cooperation locally between chiropractors and medical doctors has been building steadily over the past year and a half.

Chiropractors refer their patients to medical doctors when needed, and medical doctors have, in some cases, reciprocated by referring their patients to chiropractors. "That has not happened in the past," Gibson said.

Education is the key, say chiropractors.

"Chiropractic is a different approach," Gibson said. "I don't treat diseases. I wouldn't treat a soar throat or a bone fracture, but I do treat neuro-muscular problems."

Also, chiropractors won't prescribe medication.

Meyer said: "Today, education of chiropractors is very scientific. We don't study surgery and pharmacology. Chiropractic is based on trying to allow the body to return to homeostatus, or balance."

He said chiropractic utilizes about five or six main manipulative techniques. "Not all chiropractors utilize all the techniques. Most use a combination in their practice."

Meyer said chiropractors still are working to change the public's attitudes about the profession. "It takes a while to dispel the myths, but it's happening," he said. "Out west, nearly everyone has a chiropractor like everyone has a dentist. It's just going to take time."

Sharon Slinkard, a chiropractic patient, admitted she was reluctant at first to seek help from a chiropractor, even though her neck injury continued to worsen.

"The doctors were giving me medication and I had to wear one of those neck braces," she said. "But it kept getting worse."

Finally, Slinkard decided to try an alternative. "At first I didn't want to go to a chiropractor," she said. "I'd heard all kinds of things about chiropractors. I sure changed my tune."

The treatments helped ease the pain in her neck. "It works," she said. "That's all I can say."

But Meyer said research into other areas of chiropractic therapy is continuing and indicates patients need not think of chiropractic as a last resort.

"I think the research already shows that we are not the avenue of last resort," Meyer said. "The majority of patients with back pain should be here first."

"The research also paves the way for inter-cooperation between chiropractors and the medical establishment, and that's for the benefit of the patient."